Uterine rupture associated with misoprostol labor induction in women with previous cesarean delivery

Objective: To review our experience with uterine rupture in patients Undergoing a trial of labor with a history Of previous cesarean delivery g g in which labor was induced with misoprostol. Study design: A retrospective chart review was used to select patients who underwent induction of labor with misoprostol during the period from February 1999 to June 2002. Women with a history of cesarean delivery were retrospectively compared with those without uterine scarring. Results: Uterine rupture occurred in 4 of 41 patients with previous cesarean deliver who had labor induced with misoprostol. The rate of uterine rupture (9.7%) was significantly higher in patients with a previous cesarean delivery (P < 0.001). No uterine rupture occurcd in 50 patients without uterine scarring. Women with a history of cesarean delivery were more likely to have oxytocin augmentation than those without uterine scarring (41% versus 20%; P = 0.037). Conclusion: Misoprostol induction of labor increases the risk Of uterine rupture in women with a history of cesarean delivery. (C) 2003 Elsevier Ireland Ltd. All rights reserved.